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ICD-10/J85.1

J85.1 ICD-10-CM Code: Abscess of lung with pneumonia

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0 (FY2026), Appendix B.

  • MS-DRG 177 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC (MDC 04)
  • MS-DRG 178 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC (MDC 04)
  • MS-DRG 179 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC (MDC 04)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 283 — Empyema, Lung Abscess

Other models: CMS-HCC V22 HCC 115

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.

Official Registry Overview & Definition

Abscess of lung with pneumonia is a billable ICD-10-CM diagnosis code (J85.1).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for J85.1 in the official ICD-10-CM tabular list.

Code Also

Additional codes that may be required to fully describe the encounter.

  • the type of pneumonia

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code (B95-B97) to identify infectious agent.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to J85.1 in its code family, with their registry titles.

  • J85 — Abscess of lung and mediastinum
  • J85.0 — Gangrene and necrosis of lung
  • J85.2 — Abscess of lung without pneumonia
  • J85.3 — Abscess of mediastinum

View all codes in the J85 family

Indexed Clinical Terms (2)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic), lung (miliary) (putrid), with pneumonia
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), with, lung abscess